Art Therapy

PRACTICALImplementing the Creative Care projectn 2003.

social-care services in Suffolk identified a need for improving the skills of carers of older people in the tiuality of activities that they offer to their client group. As a result, the charity Suffolk Artlink undertook a pilot programme of arts activities in residential homes wiih the aim of tlemonstrating the value of using artists within residential care settings. Suffolk Artlink devised a programme in collaboration with professional artists, who were all t ho.sen for their ex|ierience and an approach to their work thai emphasized what the older people were able to tio (rather {han noi able to do). A series ol Creative (“are pilot projects were devised with ihe following aims: ??? To give carers working with older jieople the addiiional skills and confitlence to deliver high quality arts activities ??? To create new op[iortunities for older jXopie and their carers to take part in creative activities with profe.

ssional artists ??? To improve the cjuality of care and quality (}f life for older people ??? Ib increa.se the job .satisfaction of carers, and reduce staff turnover in care homes.IAnna MacGregor looks at how artists can be used to improve the quality of care for the elderly and benefit botb carers and customers in residential care.homes in Sutfolk using the visual arts, music, dance and creative writing. Training for the carers was built into all activities to enable the transfer of skills and thereby improve the quality of the activities delivered in the long term. The programme was designed to challenge the carers to think ahotit the way they delivered activities in new was.

and to develop an api^roach that valued the proce.ss over the product. Creative acti it does not always mean [laint and pencils. Nor do physical or mental limitations dictate child-iike activities that can Ix demeaning. The work.shcjpthemes were veiy varied and were designed lo he fun but challenging, targeting particular asjiects or senses such as movement, smell, tactility and manual dexterity.

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In order to engage the clients, the creative activities needed to be relevant to each individual. Their life experience and interests were often used as a starling point; however, these were not reminiscence sessions. For example, listening to music from different eras was used to inspire hoth drawing aTui movement, and old photographs were photocopied and knitted together to make a decorative [liece. Professional artists delivered the training in iledicateti sessions, with carers away from their customers.

These were followed by .several weekly activity sessions for older peo[ile, led by the artists and supported by the carers. This gave carers the opportunity u> huiki ttieir skills anti confidence over a period of weeks to a [loint where they felt comfortable in leading the work. In the dedicated training sessit)ns, carers were able to have a go at different arts activities and given free time to experi-Why arts activitiesArLs activity can be adaptable, varietl and responsive to situation: creating is part ol human nature. It can be communal or solitai7 action, it can be physically demanding or quietly calming, it promotes a sense of satisfaction and it has been proven to kiwer bkMid pressure and promote a sense of welibeing and raising of morale. There is no right and wrong in creating, therefore there is no defined success or failure (>Kright, 2006).The Creative Care programmeBetween 2003 arul 200=;.

Suffolk Artlink delivered programmes ot activities in careAnna MacGregor is Director, Suffolk Artiink, 9 New Cut, Halesworth, Suffolk IP19 8BYNursing & ResicJential Care, March 2006. Vol 8, No 3131 PRACTICALment. They were also asked to analyse what happened in the sessions with the older people, and plan and deliver tlieir own workshops.The projectsArts and crafts training hns and craft training was delivered in two very different settings; a home for people with tlementia and with wardens anti residents from five sheltered housing .schemes. The project aimed to develop skills anti confidence in carers in using a range of arts and crafts materials and processes with their clients. The training consisted of: LLse of a number of materials including [laints, clay, different pajx-rs and aits tools ??? The best materials to buy for clients and where to get them ??? Exploring basic art technic|ues such as glueing and fixing, clay modelling, [lrint making, felt making and glass painting ??? How to tiest dis[ilay work. Multi-art form training CusLomei”s and carers at a day care centre tcH)k part in a series of 30 workshops with five* different artists working in difTerent ???art forms.

Some workshops usetl familiar technitjues like drawing, collage or writing; others were more experimental and challenging. liiusLial workshops inckided photocopying old photografihs and knitting these together to form lacy material, or exploring the many uses of the human hand through deconstructing gloves and reassembling them in different cotiibinations. Bo. 1 gives .some example workshop themes. Dance Suffolk .

Vtlink is currently delivering our first dance-based Creative Care project. The therapeutic dance sessions, led by a professional dancer, aim to use dance movements to create a sense of mental wellbcing for residents while [iroviciing gentle exercise. Therapeutic d:ince has the potential to make people feel g(Hxl about themselves, but it is different to dance movement theraiiy. which focuses more on healing the iiody. lhc sessions are chair based and therefore safe for all customers to take part anti work within their own range of movement. A tr:iining session for carers at the start of the project looked at how to deliver sessions safely, including how to warm up.how to stretch and how to support the body.

The training also looked at how to engage participants through using dances of different generatiotis as inspiration.What were the benefitsThe- [irojecls demonstrated tliat the use of artists in residential care, combinetl with a training programme for carers, has boih temporary and longer-lasting benefits foiboth carers and iheir clients. Immediate benefits included proii.iing enjoyable time ftir carers and their clients.

Boxl.EXAMPLE WORKSHOP THEMES ??? Hand signals: This workshop looks at our sense of touch and how we can become more aware of the different textures and surfaces of things. ??? Potting, poetry and print: An opportunity to discuss ideas of the garden as a sanctuary. Create a poetic piant label and pot up a herb to accompany this. Make your own plant paper by printing from leaves and other garden objects.

132Nursing & Residential Care, March 2006, Voi 8, No 3 Arts-based therapiesThe workshops stimulated activity, engagement and interaction among older people while at the same time developing the skills of carers. They created a happy atmosphere; there was no agitation and clients were awake and taking part or enjoying watching the others. The sessions were also successful in stimulating activity among [leople with dementia (Wright, 2006). lx)nger-term benefits were achieved by giving the carers new skills to deliver workshops.

Carers were able to take on board nevv ajiproaches to delivenng arts activities that alLied such things as participation and process over the pnxluct, and the use of highc|uality arts materials. Carers were enabled to continue the work once the projeci had finished and have passed the skills on to colleagues, thus creating a sustainable benefit:Residents who were tentative about using their hands in the first sessions were able to join in and create beautiful artwork by the end. Hands that had forgotten how to cut and paint responded to gentle encouragement. (Blue King, artist) I have enjoyed it very much and have gained more confidence especially in organizing and planning sessions and involving other carers..

.Some of the residents with severe dementia can become very isolated and I think this encourages them to interact with one another. (Valerie Hart, carer)ConclusionThe detailed pilot iirojects delivered hy artists in care homes for the elderly and those with dementia [irovetl the benefits of and need tor more creative activity in care homes, .^its activities delivered in these cnironments can: ??? Help with a sense of purpose and morale ??? Promote a sense ot achievement ??? Provide stimulaiing activity ??? Promote grou|i/communal relationships ??? I lelp with health issues (such as manual dexterity and mobility) ??? Relieve loneliness ??? Restore a feeling of [lurpose ??? Introduce new skills (Wright, 2006). The following recommendations for using artists in residential care settings have been drawn from ihe initial pilot phase: ??? Carers should be given dedicated time away from their clients. An introductory session or sessitins with the carers isThe future.Sufti)lk .

^irlink has received funding from the Euro[)ean Social Fund to develop the Creative Carers programme and work with eight care centres initially. The grant will allow us to work with several care centres at one time over a period of 9 months, bringing together the care staff from different centres for training, discussion and peer support. The Creative Care programme will be Ixtsetl on ihe multi-art form pilot project and is being developed in partnership with lead artist and trainer Caroline Wright. The jjrogramme will involve several artists and will enable carers to draw on a number of art forms when delivering their activity sessions. The programme will also provide training for volunteers, mentoring, resources in the form of an boxes and a regular newsletter to enable dialogue between participants.essential in building their confidence. ??? Training sessions are more succe.ssful if two or more carers from the same centre are learning new skills together, ??? Customers should be encouraged to do the art activity themselves, rather than being led by the carers.

??? The supiiort and commitment of centre managers is an essential ingredient of successful arts [programmes. ??? A space should Ixf dedic ated to workshop sessions, free from othei” distractions. For more information about the Creative Care programme, plea^ i nni.ict Suffolk on U19K6 H-.W^i. NRCWright C (2006} Creative Carers: A Plan.

Suffolk Artlink (in pres.slFurther readingSlarja)ff K (2005) A .study of the c^ffects of visual and performing arts in health cure. www.

clieKvc.st,nhs.uk,ahoLit_|iages/ho.spital arts, htm (arcessed 01/06)KEY POINTSThe arts can have a powerfui effect on the welibeing of older people.

Professionai artists can bring new skills and inspiration to carers. Dedicated training sessions for carers shouid be provided in activity progammes by artists. Carers should be encouraged to abandon preconceptions of what the outcome of an activity might tie. In the creative process the focus shouid be less on right or wrong and more on the process itself.Nursing & Residential Care, March 2006, Vol 8, No 3